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Benznidazole


General information

Benznidazole, a nitroimidazole, is used in the treatment of Trypanosoma cruzi infections and Chagas’ disease, and is recommended for use in urogenital trichomoniasis, all forms of amebiasis, giardiasis, and anaerobic infections. Its adverse effects are similar to those of metronidazole [ ]. Drowsiness, dizziness, headache, and ataxia occur occasionally. With prolonged and/or high doses, transient peripheral neuropathy and epileptiform seizures can be seen. Other frequently mentioned adverse effects are unpleasant taste, furred tongue, nausea, vomiting, and gastrointestinal disturbances. Skin rash and pruritus can occur. One case each of erythema multiforme and of toxic epidermolysis have been reported. Benznidazole causes a disulfiram-like effect with ethanol.

General adverse effects and adverse reactions

The adverse effects of benznidazole and adverse reactions to it can be classified into three groups [ , ]:

  • 1.

    adverse effects of bone marrow suppression—thrombocytopenia, and agranulocytosis are the most severe manifestations;

  • 2.

    adverse reactions due to hypersensitivity—dermatitis with skin eruptions (usually occurring at 7–10 days of treatment), generalized edema, fever, lymphadenopathy, and joint and muscle pains;

  • 3.

    peripheral polyneuropathy, paresthesia, and polyneuritis.

In a Cochrane systematic review the incidence of adverse effects was less than 20% [ ]. In one study, under 5% of participants complained of a variety of minor symptoms, but rash and pruritus were reported more commonly. In children the drug was well tolerated and there were no severe adverse effects. The only study in adults reported a non-quantified variety of mild adverse effects (skin reactions, peripheral neuropathy, digestive disturbances), but it was said that they were less intense than those seen with nifurtimox.

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